Competency-based medical education in ophthalmology residency training: a review.

Competency-based medical education (CBME) is an outcomes-based training model that has become the new standard of medical education internationally. Regulatory and accrediting bodies have responded by establishing key competencies that residency programs may use to reshape their curricula. Available literature on the implementation of CBME in ophthalmology residency training programs across North America was examined. Ophthalmology-specific residency training objectives and milestones have been proposed within North America in the last 4 years. Curriculum guidelines and implementation blueprints and principles have also been proffered from various sources internationally but have met with some barriers. Assessment tools within ophthalmology have seen the most innovative development within the domain of surgical skills objectives. Competencies outside of the medical expert and patient care roles have proven more challenging to teach and assess. One ophthalmology program in Canada has undergone early implementation of a novel CBME curriculum. There is still considerable work to be done to successfully implement CBME curricula within ophthalmology residency programs in North America. Collaborative efforts to develop customizable curricula, tackle implementation barriers, and create specific assessment modalities will assist programs in meeting the competency mandates of CBME.

Competency-Based Education Assessment Tools for Laser Capsulotomy, Peripheral Iridotomy, and Selective Laser Trabeculoplasty.

PURPOSE: To produce Competency-Based Education Assessment Tools (C-BEAT) for performance of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy, laser peripheral iridotomy (LPI), and selective laser trabeculoplasty (SLT) on an artificial eye model that can be used in competency-based medical education (CBME) of ophthalmology residents. DESIGN: Survey. PARTICIPANTS: Eight content experts (residency program director and faculty members involved in ophthalmology resident training). METHODS: Task-specific checklists were created to assess the performance of Nd:YAG capsulotomy, LPI, and SLT on artificial eye models designed for each of these procedures, as well as a global rating scale (GRS). A modified Delphi process was used to establish face and content validity of the C-BEAT for lasers. Eight content experts participated in the Delphi process, and the consensus was achieved after 4 rounds. MAIN OUTCOME MEASURE: Survey responses. RESULTS: Final versions of checklists for Nd:YAG capsulotomy, LPI, and SLT, and a GRS for these laser procedures were produced with face and content validity. Modifications to the energy settings and the number of applications in the capsulotomy and peripheral iridotomy were implemented into the checklist and instructions, because the artificial models were not identical in their responses to the laser applications compared with real tissue. CONCLUSIONS: The C-BEAT for lasers can be used in an examination setting within ophthalmology residency training programs to establish competency in these procedures before performing them on real patients. These tools help to meet the demand for assessment modalities within a CBME model that is being implemented into residency training worldwide. To establish interrater and construct validities, further studies are required.